Project 1: The Environmental Riskscape, Disasters and Obstetric Outcomes

项目 1：环境风险状况、灾害和产科结果

• 批准号: 10602560
• 负责人: Kristina Walker Whitworth
• 金额: $ 33.31万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-16 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10602560
• 关键词: Address; African American; African American population; American; Anthracenes; Area; Aromatic Polycyclic Hydrocarbons; Benzo(a)pyrene; Biological; Birth; Case/Control Studies; Chemical Exposure; Chemicals; Child; Color; Communities; Complex; Computerized Medical Record; Data; Development; Disasters; Environment; Environmental Health; Epidemiology; Event; Exposure to; Family; Floods; Fluorine; Foundations; Future; Genetic; Goals; Hazardous Waste Sites; Health; Healthcare; Hurricane; Individual; Industry; Infant; Infant Health; Maternal Exposure; Maternal Health; Maternal and Child Health; Medicine; Metal exposure; Metals; Morbidity - disease rate; Mothers; Natural Disasters; Neighborhoods; Not Hispanic or Latino; Outcome; Perinatal; Personal Satisfaction; Physical environment; Placenta; Play; Population; Population Heterogeneity; Poverty; Predisposition; Pregnancy; Pregnant Women; Premature Birth; Questionnaires; Race; Research; Research Project Grants; Rest; Risk; Role; Sampling; Social Environment; Source; Statistical Methods; Term Birth; Texas; Woman; Work; biobank; black/white disparity; built environment; chemical association; college; data repository; design; disorder risk; disparity reduction; economic cost; environmental health disparity; experience; health disparity; health disparity populations; improved; low socioeconomic status; mortality; obstetric outcomes; pollutant; preventive intervention; racial disparity; response; societal costs; stressor; successful intervention; superfund site

Despite advances in health care, African-Americans (AA) continue to experience a disproportionate burden of poor obstetric outcomes. This is alarming as pregnancy is a window of future health and many obstetric outcomes, such as preterm birth, are associated with severe morbidity and mortality for both the mother and her infant and result in high societal and economic costs. Unfortunately, the origin of racial disparities in obstetric outcomes does not appear to be genetic nor fully explained by individual-level factors; thus, we must look toward the broader context in the physical, built, and social environments to mitigate racial disparities in maternal health. Because communities of color and low socioeconomic status experience a higher burden of chemical exposures, in part due to the proximity of their neighborhoods to key exposure sources (e.g., industry and hazardous waste sites), ‘environment’ has been hypothesized to be a driver of racial disparities in obstetric outcomes. Two classes of pollutants with historic contamination in Houston, TX are polycyclic aromatic hydrocarbons (PAHs) and metals, which have each been positively associated with preterm birth. Additionally, under an environmental riskscape framework, place-based stressors may also contribute to racial disparities in maternal health by directly influencing disease risk and by modifying women’s susceptibility to chemical exposures. Enhanced understanding of the role of the riskscape, and mixtures of chemical and non-chemical stressors, in racial disparities in obstetric outcomes would promote efforts to design successful interventions and improve the wellbeing of health disparity populations. Finally, Houston is a disaster-prone area, which may result in increased exposures to chemical, biological and non-chemical stressors that may be heightened among health disparity populations. Our goal is to mitigate maternal and infant health disparities in an overburdened population living in a disaster-prone region. To achieve this goal, the Objective of this Research Project, The Environmental Riskscape, Disasters and Obstetric Outcomes, is to utilize a large-scale perinatal biobank and data repository (PeriBank) at Baylor College of Medicine to characterize racial disparities in the riskscape of AA and non- Hispanic white (NHW) pregnant women in Houston, to assess associations between the mixture of chemical and non-chemical stressors in the riskscape on preterm birth, and explore the impact of a natural disaster of unprecedented magnitude (Hurricane Harvey) on racial disparities in chemical exposures. Through the application of a riskscape-based approach paired with statistical methods to address mixture effects, the results from this study will enhance our understanding of the roles of chemical and non-chemical stressors in racial disparities in preterm birth in a disaster-prone region. This work will lay the foundation for future studies to improve our understanding of drivers of black-white disparities in obstetric outcomes, research that is imperative for the development and successful implementation of preventive interventions to mitigate these disparities.

尽管在医疗保健方面取得了进步，但非洲裔美国人（AA）仍在承受着不受欢迎的负担 产科结果不佳，因为怀孕是未来的窗口 诸如早产之类的结果与母亲和她的病态和死亡率有关 不幸的是，婴儿和经济成本很高。 结果似乎不是遗传性的，也不是由个体级别的因素完全解释的。 物理，建筑和社会环境中更广泛的背景，以减轻孕产妇健康中的种族劳累差异。 因为有色人种和低社会经济地位的社区经历了更高的化学暴露负担，所以 部分原因是他们社区靠近关键的接触来源（行业和危险废物（ 站点）“环境”被认为是产科结果中种族差异的驱动力。 德克萨斯州休斯顿的历史污染物的污染物是多环芳烃（PAHS）和金属， 在环境风险景观下，每个人都与早产相关。 框架，基于地点的压力源也可能导致孕产妇健康的种族差异 影响疾病的风险并通过改善妇女对化学暴露的影响 了解风险景观的作用以及化学和化学应激源的混合物 产科成果的差异将促进主体设计成功的干预措施，并改善 健康差异的福祉。 在健康差异之间可能会增加化学，生物学和非化学胁迫的暴露 人口。 一个易灾的地区。 风险景观，灾难和产科结果是利用大规模的围产期生物库和数据存储库 （Peribank）在贝勒医学院（Baylor College 休斯敦的西班牙白人（NHW）孕妇，以评估化学的混合物 风险景观对早产的非化学压力源，并探索自然灾害的影响 史无前例的大幅度（哈维飓风）在化学曝光中的种族差异 基于风险景观的方法与统计方法搭配以解决混合效应，结果 从这项研究中将增强我们对化学和非化学应激源在种族中的作用的理解 易于灾难的地区的早产差异 提高我们对产科结果中黑白差异的驱动因素的理解 为了开发和成功实施这些差异。